Recently in Dehydration / Malnutrition / Urinary Tract Infections Category

Dehydration is a serious medical condition that occurs when the amount of water leaving the body is greater than the amount being taken in.  Dehydration is common in elderly people as a result of physiological changes in the body resulting in loss of protein which holds water, decrease of kidney urine concentrating abilities resulting in frequent urination, and decreasing thirst.  Many medications, including blood pressure medication, anti-depressants and laxatives, also cause dehydration. 

Dehydration often goes undiagnosed and untreated in elderly nursing home patients.  Fluid volume deficits can have devastating consequences such as causing kidney failure, seizures, swelling of the brain, hypovolemic shock, and increases a resident's susceptibility to urinary tract infections in females.  Ultimately, dehydrated nursing home residents may develop sepsis resulting in death because their ability to fight infections has been compromised.   

The standard of care for residents in nursing homes requires the nursing home staff to provide each resident with sufficient fluid intake to maintain proper hydration and health.  Nursing homes should develop, implement and (when needed) revise care plans to protect residents from fluid volume deficits and water deprivation.  Fortunately, the potentially fatal consequences of dehydration can be prevented if the nursing home staff takes preventative actions including recording daily food and fluid intake, monitoring body weight on a daily basis and implementing a hydration program that provides water during and between meals.  The nursing home must carefully and thoroughly monitor fluid and nutritional support and initiate appropriate treatment when intake falls below adequate levels.

Please feel free to contact the nursing home neglect attorneys at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury or wrongful death as a result of dehydration/malnutrition, bed sores (also known as pressure sores or decubitus ulcers), nursing home falls, medication error/prescription mistake, elder abuse or elder neglect.

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Dehydration occurs when the amount of water leaving the body is greater than the amount being taken in.  Dehydration occurs frequently in elderly people as a result of physiological changes in the body resulting in loss of protein which holds water, decrease of kidney urine concentrating abilities resulting in frequent urination, and decreasing thirst.  Additionally, many medications, including blood pressure medication, anti-depressants and laxatives, cause dehydration. 

The standard of care for residents in nursing homes requires the nursing home staff to provide each resident with sufficient fluid intake to maintain proper hydration and health.  Nursing homes should develop, implement and (when needed) revise care plans to protect residents from fluid volume deficits and water deprivation.  The potentially fatal consequences of dehydration can be prevented if the nursing home staff takes preventative actions including recording daily food and fluid intake, monitoring body weight on a daily basis and implementing a hydration program that provides water during and between meals.  The nursing home must carefully and thoroughly monitor fluid and nutritional support and initiate appropriate treatment when intake falls below adequate levels.

Elderly dehydration often goes undiagnosed and untreated in nursing home patients.  Fluid volume deficits can have devastating consequences such as causing kidney failure, seizures, swelling of the brain, hypovolemic shock, and increases a resident's susceptibility to urinary tract infections in females.  Ultimately, dehydrated nursing home residents may develop sepsis resulting in death because their ability to fight infections has been compromised.   

Under Maryland law, when a nursing home resident dies as a result of nursing home negligence, two causes of action arise: (1) a wrongful death claim; and (2) a survivorship claim.

A sample Maryland Circuit Court Wrongful Death/Survivorship Complaint involving claims of nursing home negligence relating to dehydration/malnutrition follows:

COMPLAINT

 Plaintiffs, [insert name], individually and as personal representative of the Estate of [insert name], [insert names of wrongful death beneficiaries], by their attorneys, David L. Feldstein and Dever & Feldstein, LLC, hereby file this Complaint against Defendants, [insert names], and in support thereof state as follows:

PARTIES AND JURISDICTION

 1.   At all times material to this case, Plaintiffs have been citizens and residents of the State of Maryland.  Plaintiffs [insert names] are the surviving children of the decedent, [insert name].  [Insert names] are wrongful death beneficiaries in this action pursuant to Section 3-904(a) of the Courts and Judicial Proceedings Article of the Maryland Annotated Code.
 2. [Insert name] is the duly appointed Personal Representative of the Estate of [insert name].  The Register of Wills for Baltimore County issued Letters of Administration to [insert name] on [insert date].  The Estate of [insert name] is bringing this survival action pursuant to Section 7-401(x) of the Estates and Trusts Article of the Maryland Annotated Code.
 3. At all times material to this case, [insert Defendants] have been operating nursing homes and engaging in the practice of medicine and rehabilitation services in Baltimore City and throughout Maryland, acting through actual and/or apparent agents, servants and/or employees.
 4. The venue for this claim is proper in Baltimore City, Maryland.  The amount in controversy exceeds Thirty Thousand Dollars ($30,000.00).

FACTS COMMON TO ALL COUNTS

5. At all times mentioned and relevant herein, [insert Defendant] has been licensed by the State of Maryland to own and operate nursing homes in Maryland and has held itself and its agents, servants and employees out to the general public as experienced, competent and capable providers of medical and rehabilitation services, and in such capacity owed a duty to [insert name] and the Plaintiffs to render that degree of medical care and skill which is ordinarily rendered by those who devote special study and attention to the practice of medicine and rehabilitation services. 
6. At all times mentioned and relevant herein, all individuals at [insert Defendant] who participated in the care provided to Plaintiff were acting on behalf of [insert Defendant] and within the scope of their employment and/or agency with [insert Defendant] 7. On or about [insert date], [insert name] was admitted to the [insert Defendant] nursing home located at [insert address].  [Insert name] suffered from dementia and Parkinson's disease and required assistance with the activities of daily living. 
8. On or about [insert date], the staff at [insert Defendant] found [insert name] non-responsive with difficulty breathing and called 911.  Emergency medical technicians arrived and intubated [insert name] before transporting her to the emergency room at [insert name] Hospital where she was immediately noted to be cyanotic and cachectic.  An oral exam revealed that [insert name] tongue was "quite dry" and her mouth was filled with dried food and a copious amount of purulent secretions.  [Insert name] was transferred to the Intensive Care Unit and diagnosed with respiratory failure, severe electrolyte imbalances, and metabolic acidosis, all secondary to massive dehydration.  After lengthy discussions with doctors at [insert name], the family elected to discontinue ventilator support and other aggressive therapy.  [Insert name] died on [insert date].  The Death Certificate lists the primary cause of death as dehydration of 10 days duration.

COUNT I (Professional Negligence)

  9. The Plaintiffs incorporate all of the allegations contained in the above paragraphs as if those allegations are set forth in this Count.
 10. Defendants, individually and through their actual and/or apparent agents, servants and/or employees, owed Plaintiff a duty to exercise reasonable care in their treatment of her.
 11. Defendants, individually and through their actual and/or apparent agents, servants and/or employees, breached the above-described duty of care to Plaintiff, thereby deviating from the applicable standards of care, and were otherwise negligent, careless and reckless in that they, among other things:

(a) failed to provide [insert name] with adequate fluids and nutrition, resulting in prolonged and massive dehydration and cachexia, severe electrolyte imbalances, metabolic acidosis, multi-organ failure, and ultimately, death;
(b) failed to timely and properly diagnose and treat [insert name]'s dehydration and related complications; 
(c) failed to provide [insert name] with necessary medical monitoring, care and treatment; and
(d) were otherwise negligent and violated the applicable standards of care.

 12. As a direct and proximate result of the above-described deviations from the applicable standards of care and breaches of duty by Defendants, [insert name] was caused to sustain serious, painful and permanent injuries to her body, including great physical and mental pain and suffering, and, ultimately, death.
 13. As a further direct and proximate result of the above-described deviations from the applicable standards of care and breaches of duty by Defendants, [insert name], among other things, was forced to undergo medical procedures and treatment, and, as a result, was obliged to expend sums of money for medical, hospital and other care and treatment and was precluded from engaging in her normal and usual pursuits and activities, among other injuries and damages.
 14. Had Defendants followed the appropriate and applicable standards of care, [insert name] would not have suffered the above-identified injuries, damages and death.
 15. The injuries herein complained of were directly and proximately caused by the negligence and want of care of Defendants, with no negligence on the part of [insert name] contributing thereto.

 WHEREFORE, Plaintiffs request that a judgment be entered against the Defendants for compensatory damages in excess of Thirty Thousand Dollars ($30,000.00) and any other relief to which this Court finds them entitled.

COUNT II (Wrongful Death)

 16. The Plaintiffs incorporate all of the allegations contained in the above paragraphs as if those allegations are set forth in this Count.
 17. As a direct and proximate result of the Defendants' above-described negligence in causing the death of the Plaintiff, [insert wrongful death beneficiaries] have sustained, among other things, pecuniary loss, mental anguish, emotional pain and suffering, loss of society, loss of companionship, loss of comfort, loss of protection, loss of parental care, loss of filial care, loss of attention, loss of advice, loss of counsel, loss of guidance and loss of education. 

 WHEREFORE, the Plaintiffs request that a judgment be entered against the Defendants for compensatory damages in excess of Thirty Thousand Dollars ($30,000.00) and any other relief to which this Court finds them entitled.

*  *  *

Please feel free to contact the nursing home neglect lawyers at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury or wrongful death as a result of dehydration/malnutrition, bed sores (also known as pressure sores or decubitus ulcers), nursing home falls, medication error/prescription mistake, elder abuse or elder neglect.

Contact Our Firm
Your Name: Email Address: Phone Number:

As the United States' population grows older, more and more individuals become vulnerable and dependent upon others to meet their most basis needs forcing families to place their loved ones in nursing homes.  Unfortunately, many nursing homes are understaffed and/or unable to provide their residents with all of the care that they may require.  According to the United States Centers for Disease Control ("CDC"), a 1996 study found that more than 500,000 people age 60 or older were victims of neglect or abuse during a one-year period.  

For instance, nursing home residents may develop infected stage 3 or infected stage 4 bedsores (also known as pressure sores or decubitus ulcers), dehydration or malnutrition resulting in painful and life-threatening injuries.   These conditions do not happen overnight; rather, they develop over time as the result of the nursing home's failure to provide basic care and attention on an hourly and daily basis.

In our experience, the nursing home staff is able to figure out when a resident does not receive visitors, and the consequences can be fatal.  Family members should make regular nursing home visits (at unpredictable times) in order to check on their loved one, inspect their skin for breakdown and speak with the nursing home staff regarding oral intake.  The failure to do so can have tragic results. 

For instance, we handled a case involving an elderly woman who required assistance with all activities of daily life and was placed into a nursing home.  Her children had busy and hectic lives, and very rarely visited the nursing home.  One day, she was found non-responsive and transported to the hospital where she was diagnosed with respiratory failure, severe electrolyte imbalances, metabolic acidosis, and multi-organ failure all secondary to massive dehydration and malnutrition.  Disturbingly, oral examination revealed that her mouth was filled with dried food and purulent secretions as food was being haphazardly stuffed into her mouth by the nursing home staff.  She died three days later due to dehydration and malnutrition.  Our medical experts concluded that this condition was the result of severe water and food deprivation occurring over an extended time period.  

The lesson to be learned is that family members must be the biggest advocates for their loved ones and make regular nursing home visits at unpredictable times.  As the saying goes, "the squeaky wheel gets the grease."

Please feel free to contact the nursing home neglect attorneys at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury or wrongful death as a result of dehydration, malnutrition, bedsores (also known as pressure sores or decubitus ulcers), nursing home falls, medication error/prescription mistake, elder abuse or elder neglect.

Contact Our Firm
Your Name: Email Address: Phone Number:

The United States Centers for Disease Control and Prevention ("CDC") has recognized that as the American population grows older, more and more individuals become vulnerable and dependent upon others to meet their most basis needs.  According to the CDC, a 1996 study found that more than 500,000 people age 60 or older were victims of neglect or abuse during a one-year period.  

Sadly, nursing home residents are all too often killed as a result of nursing home neglect or abuse.  For instance, nursing home residents may develop infected stage 3 or infected stage 4 bedsores (also known as pressure sores or decubitus ulcers), experience falls, dehydration, malnutrition, or medication errors/prescription mistakes resulting in painful and life-threatening injuries. 

Under Maryland law, when a nursing home resident experiences death secondary to nursing home negligence, two causes of action arise: (1) a wrongful death claim; and (2) a survivorship claim.

First, the wrongful death claim is a statutory cause of action governed by Sections 3-901 et seq. of the Maryland Courts and Judicial Proceeding Article of the Maryland Annotated Code.  The Maryland Wrongful Death Statute makes clear that there can only be "one action . . . in respect to the death of a person."  See Section 3-904(f).  Section 3-904 sets forth the categories of individuals who are wrongful death beneficiaries.  Generally, the decedent's surviving parents, spouse and surviving biological or legally adopted children are wrongful death beneficiaries who must be included in a claim for wrongful death.  Because there can only be one cause of action for wrongful death, it is required that all wrongful death beneficiaries be joined as plaintiffs and named in the lawsuit.

The wrongful death claim seeks to collect damages suffered by the wrongful death beneficiaries in their own right as a result of losing their loved one.  Wrongful death beneficiaries are generally entitled to seek monetary recovery for their emotional pain and suffering experienced secondary to the loss of their family member.  These damages are subject to Maryland's Noneconomic Damages Cap.

The second cause of action arising following the death of a nursing home resident is the survivorship claim.  This claim is brought on behalf of the decedent's estate by the personal representative of the estate.  In situations where the decedent had a will, the personal representative is named in the will.  In the event the nursing home resident dies without a will (also known as dying intestate), it may be necessary to file a Petition for a Small Estate for litigation purposes in the Orphan's Court of the Maryland County where the decedent resided at the time of his or her death in order to have a personal representative appointed.

The survivorship claim seeks to recover for certain categories of the decedent's individual damages that could have been recovered if he or she had survived, including their conscious pain and suffering resulting from the nursing home neglect (subject to Maryland's Noneconomic Damages Cap), medical bills resulting from the negligence, and funeral bills.  In essence, the personal representative of the estate steps into the shoes of the decedent in order to assert his or her claims of injury and damages.

Importantly, the personal representative does not personally recover for these claims of survivorship damages.  Rather, any monies recovered pursuant to the survivorship action must be deposited into the bank account of the decedent's Estate and distributed in accordance with his or her will (or, if there is no will, distribution is made in accordance with Maryland's laws of intestacy contained in Title 3 of the Trusts and Estates Article of the Maryland Annotated Code). 

Nursing home abuse and negligence lawsuits are vigorously defended by the nursing home and their insurance company and attorneys.  Ultimately, successful recovery in these cases require that the surviving family members and wrongful death beneficiaries unite and work together in cooperation as a team in the pursuit of the case so that the underlying circumstances can be investigated promptly, and then litigated aggressively by the lawyers representing the family.    

Please feel free to contact the nursing home neglect attorneys at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury or wrongful death as a result of bedsores (also known as pressure sores or decubitus ulcers), nursing home falls, dehydration/malnutrition, medication error/prescription mistake, elder abuse or elder neglect.

Contact Our Firm
Your Name: Email Address: Phone Number:
It is common knowledge that water is essential for human life. 
 
Nursing home residents are often at risk for dehydration.  Simply stated, dehydration occurs when a person loses more water than they take in.   Water deprivation can have serious life threatening consequences.  Sadly, in our experience, nursing homes all too often fail to take appropriate measures to prevent this most treatable and preventable condition.
 
There are many reasons that dehydration occurs frequently in elderly people including physiological changes in the body resulting in loss of protein which holds water, decrease of kidney urine concentrating abilities resulting in frequent urination, and decreasing thirst.  Additionally, many medications, including blood pressure medication, anti-depressants and laxatives, cause dehydration.  Making matters worse, many elderly nursing home residents are totally dependent upon the nursing home staff to obtain adequate fluid intake as a result of cognitive and physical disabilities.    
 
Most physicians would agree that the minimal standard of care for residents in nursing homes requires the nursing home staff to provide each resident with sufficient fluid intake to maintain proper hydration and health.  Nursing homes should develop, implement and (when needed) revise care plans to protect residents from fluid volume deficits.  The potentially fatal consequences of dehydration can be prevented if the nursing home staff takes preventative actions including recording daily food and fluid intake, monitoring body weight on a daily basis and implementing a hydration program that provides water during and between meals.  The nursing home must carefully and thoroughly monitor fluid and nutritional support and initiate appropriate treatment when intake falls below adequate levels.
 
Unfortunately, elderly dehydration often goes undiagnosed and untreated in nursing home patients.  Fluid volume deficits can have devastating consequences such as causing kidney failure, seizures, swelling of the brain, hypovolemic shock, and increases a resident's susceptibility to urinary tract infections in females.  Ultimately, dehydrated nursing home residents may develop sepsis resulting in death because their ability to fight infections has been compromised.    
 
In recognition of the importance of preventing dehydration, the Health Care Financing Administration (also known as the Centers for Medicare & Medicaid Services) has classified dehydration as a "sentinel event" that can trigger a broader investigation of a nursing home by state surveyors.  The development of pressure sores (also known as bed sores or decubitus ulcers) is also classified as a "sentinel event." 
 
Please feel free to contact the lawyers at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury as a result of dehydration, urinary tract infection or elderly abuse or neglect
Contact Our Firm
Your Name: Email Address: Phone Number:

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This page is an archive of recent entries in the Dehydration / Malnutrition / Urinary Tract Infections category.

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